Nine Digestive Disease Myths
Medical Reviewers and Editors: Jay W. Marks, MD, and Melissa Conrad Stöppler, MD
Researchers have only recently begun to understand the many, often complex,
diseases that affect the digestive system. Accordingly, people are gradually
replacing folklore, old wives' tales, and rumors about the causes and treatments
of digestive diseases with accurate, up-to-date information. But
misunderstandings still exist, and, while some folklore is harmless, some can be
dangerous if it keeps a person from correctly preventing or treating an illness.
Listed below are some common misconceptions (fallacies), about digestive
diseases, followed by the facts as professionals understand them today.
Myth # 1 Ulcers: Spicy food and stress cause stomach ulcers.
False
The truth is, the majority of stomach ulcers are caused either by infection with a bacterium called Helicobacter pylori (H. pylori) or by use of pain medications such as
aspirin, ibuprofen, or naproxen, the so-called
nonsteroidal antiinflammatory drugs (NSAIDs). Most
H. pylori-related ulcers can be cured with antibiotics.
NSAID-induced ulcers can be cured with time, stomach-protective medications, antacids, and avoidance of NSAIDs. Now that it is appreciated that H. pylori and NSAIDs are the cause of most ulcers and patients are being managed appropriately, the ulcers that are coming to medical attention are increasingly likely to be unrelated to
H. pylori or NSAIDs. Spicy food and
stress (except when associated with extreme medical conditions) may aggravate ulcer symptoms in some people, but they do not cause ulcers.
Ulcers can also be caused by cancer.
Myth # 2 Heartburn: Smoking a cigarette helps relieve heartburn.
False
Actually, cigarette smoking may contribute to
heartburn. Heartburn occurs when the lower esophageal sphincter (LES) - a muscle between the esophagus and stomach - relaxes, allowing the acidic contents of the stomach to splash back (reflux) into the esophagus. People who smoke more frequently have inflammation of the esophagus (esophagitis), presumably caused by increased reflux of acid, that is the basis of heartburn. The increased reflux is believed to be due to the fact that cigarette smoking causes the LES to relax.
Myth # 3 Celiac Disease: Celiac disease is a rare childhood disease.
False
Celiac disease affects both children and adults. About 1 in 200 people in the United States have the genetic predisposition for celiac disease
although not all of them have the disease. Sometimes celiac disease first causes symptoms during childhood, usually diarrhea, growth failure, and failure to thrive. But the disease can also first cause symptoms in adults of any age. These symptoms may be vague and therefore attributed to other conditions. Symptoms can include bloating and abdominal distention, flatulence, diarrhea, and abdominal pain due to the involvement of the small intestine as well as skin rash, anemia, and thinning of the bones (osteoporosis) due to malabsorption of nutrients by the diseased intestine. Celiac disease may cause such nonspecific symptoms for several years before being correctly diagnosed and treated.
People with celiac disease should not eat any foods containing
gluten, a protein in wheat, rye, and barley, whether they have symptoms or not. In celiac disease, gluten provokes an inflammatory reaction by the body that destroys the lining of the small intestine, which interferes with the absorption of nutrients. Even a small amount of gluten can cause damage, and sometimes no symptoms will be apparent.
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